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[颅底脑膜瘤:放疗后的疗效、临床耐受性及影像学评估]

[Base of the skull meningioma: Efficacy, clinical tolerance and radiological evaluation after radiotherapy].

作者信息

Brahimi Y, Antoni D, Srour R, Proust F, Cebula H, Labani A, Noël G

机构信息

Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France.

Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire de radiobiologie, UMR 7178 institut pluridisciplinaire Hubert-Curien (IPHC), université de Strasbourg, 67000 Strasbourg, France; CNRS, IPHC UMR 7178, 67000 Strasbourg, France.

出版信息

Cancer Radiother. 2018 May;22(3):264-286. doi: 10.1016/j.canrad.2017.09.010.

Abstract

Skull base meningioma leads to functional disturbances, which can significantly alter the quality of life. The optimal management of these lesions, whose goals are neurological preservation and tumour local control, is not yet clearly established. It is widely recognized that the goal of a radical excision should be abandoned despite the advances in the field of microsurgery of skull base lesions. Although less morbid, partial tumour excision would be associated with increased risk of local tumour recurrence. Although discussed both exclusive and adjuvant have proven to be highly successful in terms of clinical improvement and local control. Various radiation techniques have demonstrated their efficacy in the management of this pathology. However, high rates of clinical improvement are in contrast with low rates of radiological improvement. The notion of clinical and radiological dissociation appeared. However, in most of these studies, the analysis of the radiological response could be subject of legitimate criticism. This work proposes to review the local control, the efficacy and the clinical tolerance and the radiological response of the various radiation techniques for the meningioma of the base of the skull and to demonstrate the interest of quantitative volumetric analyses in the follow-up of meningioma after radiotherapy.

摘要

颅底脑膜瘤会导致功能障碍,这会显著改变生活质量。对于这些以神经功能保留和肿瘤局部控制为目标的病变,最佳治疗方案尚未明确确立。尽管颅底病变显微外科领域取得了进展,但人们普遍认为应放弃根治性切除的目标。虽然创伤较小,但部分肿瘤切除会增加局部肿瘤复发的风险。尽管有关于单纯放疗和辅助放疗的讨论,但二者在临床改善和局部控制方面均已证明非常成功。各种放疗技术已在这种疾病的治疗中显示出其疗效。然而,高临床改善率与低放射学改善率形成对比。临床与放射学分离的概念由此出现。然而,在大多数这些研究中,对放射学反应的分析可能会受到合理批评。这项工作旨在回顾各种放疗技术对颅底脑膜瘤的局部控制、疗效、临床耐受性和放射学反应,并证明定量体积分析在脑膜瘤放疗后随访中的意义。

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